Knotless suture repair for chronic lateral ankle instability: A systematic review & single- arm meta-analysis

Title : Knotless suture repair for chronic lateral ankle instability: A systematic review & single- arm meta-analysis

Abstract:

Introduction: There is a need to assess the use of knotless sutures in cohorts with Chronic Ankle Instability (CAI). Methods: A literature search of PubMed, Ovid MEDLINE, Embase, Cochrane Library and SCOPUS was conducted from each database’s inception to 15 August 2025. Eligible studies reported patients with CAI undergoing foot and ankle surgery with knotless suture repair. This review was registered in PROSPERO (ID: CRD1106305).

Results: A total of 10 studies comprising 500 patients met the eligibility criteria. Karlsson-Peterson (KP) scores preoperatively were 62.75. (95% CI: 61.16–64.34, I²=79%) and at final follow-up were 88.03 (95% CI: 84.20–91.87, I²=97%). Visual analogue scale (VAS) scores preoperatively were 5.76 (95% CI: 4.42–7.10, I²=100%) and at final follow-up were 1.20 (95% CI: 0.77–1.64, I²=96%). The overall complication rate was 5% (95% CI: 0.03–0.08, I²=53%). The reoperation rate was 2%(95% CI: -0.00–0.03, I²=0%).

Conclusion: The use of knotless-based CAI repair appears both efficacious and safe, with similar relief in the short term and during follow-up, up to and beyond a year after the procedure. Direct comparative studies against traditional Brostrom-Gould knotted approaches are warranted to determine the gold standard in CAI repair moving forward, along with further investigation into its functional outcomes.

Keywords: chronic ankle instability; knotless repair; Brostrom-Gould; function; ATFL; CFL; meta-analysis.

Biography:

Hussein Jaber is a fourth-year medical student with a strong interest in orthopaedics, inspired in part of his director of studies, an orthopaedic surgeon. He drawn to the specialty for its combination of hands-on surgical skill and meaningful patient outcomes. His passion for research has led him to projects such as knotless anchor repair in chronic ankle instability, as well as related studies, reflecting my commitment to advancing the field. He aspire to contribute to evidence-based practice, ensuring that future surgical techniques are guided by robust clinical research and deliver the best outcomes for patients.